Massachusetts

In addition to releasing their 2017 enrollment data for the first 8 days of November, the Massachusetts Health Connector has posted their latest monthly enrollment report (through the end of October), and the news is good. As I note every month:

Unlike most states, the Massachusetts Health Connector has not only seen no net attrition since the end of Open Enrollment, but has actually seen a net increase in enrollment...mainly due to their unique "ConnectorCare" policies, which are fully Qualified Health Plans (QHPs) but have additional financial assistance for those who qualify and which are available year-round instead of being limited to the open enrollment period.

The amount of the increase depends on which "official" number you start with; the MA exchange claimed 196,554 people as of 1/31/16...while the ASPE report gives it as 213,883 as of the next day....yet their March report claims 208,000 effectuated enrollees as of February.

The most recent hard current exchange QHP enrollment number I have for Massachusetts is 230,412 people as of September 1st. Due to MA's unique "ConnectorCare" program, they've actually seen a gradual increase in exchange enrollment during the off-season instead of net attrition like almost every other state.

Today I was informed that as of November 8th, they had a grand total of 2,942 new QHP selections via the state exchange...of which 510 are fully enrolled (i.e., they've paid their January premiums already). This does not, however, include any renewals / re-enrollments by current enrollees, which could be substantially higher.

UPDATE: OK, I have the total enrollment numbers now: 10,251 (7,309 renewals + 2,942 new additions). That's 1,281 per day, or about 4.8% of their total enrollment last season.

Minnesota and Massachusetts are the only state exchanges I have data for so far, and MN is a special case, so here's a simple extrapolation of MA's numbers:

Normally I post screenshots from the revised/updated SERFF filings and/or updates at RateReview.HealthCare.Gov, but it takes forever and I think I've more than established my credibility on this sort of thing, so forgive me for not doing so here. Besides, #OE4 is approaching so rapidly now that this entire project will become moot soon enough, as people start actually shopping around and finding out just what their premium changes will be for 2017.

The other reason I'm not too concerned about documenting the latest batch of updates/additional data is because in the end none of it is making much of a difference to the larger national average anyway; no matter how the individual carrier rates jump around in various states, the overall, national weighted average still seems to hover right around the 25% level.

Still, for the record, here's the latest...in four states (Iowa, Indiana, Maine & Tennessee) I've just updated the requested and/or approved average increases. In the other four (Massachusetts, Montana, North & South Dakota) I've added the approved rate hikes as well.

The Massachusetts Health Connector has posted their latest monthly enrollment report (through the end of August), and the news is good. As I note every month:

Unlike most states, the Massachusetts Health Connector has not only seen no net attrition since the end of Open Enrollment, but has actually seen a net increase in enrollment...mainly due to their unique "ConnectorCare" policies, which are fully Qualified Health Plans (QHPs) but have additional financial assistance for those who qualify and which are available year-round instead of being limited to the open enrollment period.

The amount of the increase depends on which "official" number you start with; the MA exchange claimed 196,554 people as of 1/31/16...while the ASPE report gives it as 213,883 as of the next day....yet their March report claims 208,000 effectuated enrollees as of February.

(sigh) Here's a good example of what a royal pain in the ass trying to estimate the annual rate change filings can be. Just 2 weeks ago, I was finally able to plug in the requested 2017 rate hikes requested by just about every carrier offering individual policies in Massachusetts, filling in one of the final blank states in my 2017 rate hike project.

This was a double headache: First, because the actual enrollment numbers were only available for 3 out of 11 carriers via the filings; I had to get the rest from the MA exchange's monthly dashboard report. Secondly, even with the dashboard report, I had to merge together 2 different enrollment numbers for each carrier due to MA's unique "ConnectorCare" program.

The Massachusetts Health Connector has posted their latest monthly enrollment report (through the end of July), and the news is good. As I note every month:

Unlike most states, the Massachusetts Health Connector has not only seen no net attrition since the end of Open Enrollment, but has actually seen a net increase in enrollment...mainly due to their unique "ConnectorCare" policies, which are fully Qualified Health Plans (QHPs) but have additional financial assistance for those who qualify and which are available year-round instead of being limited to the open enrollment period.

The amount of the increase depends on which "official" number you start with; the MA exchange claimed 196,554 people as of 1/31/16...while the ASPE report gives it as 213,883 as of the next day....yet their March report claims 208,000 effectuated enrollees as of February.

Massachusetts' total individual market was only around 72,000 people in 2014, but their ACA exchange had disastrous technical problems during the first ACA open enrollment period, causing tens of thousands of Baystaters to enter a sort of "limbo" status healthcare coverage-wise (the first version of the exchange couldn't properly confirm which enrollees qualified for APTC assistance, so only those paying full price were actually enrolled in exchange QHPs; those claiming APTC status were temporarily transferred over to state-based coverage until it could be sorted out, which took nearly a year in most cases). Fortunately, in 2015, the state got their act together and enrolled nearly 214,000 people in exchange-based policies this year.

I just posted some key specs from the MA Health Connector's monthly enrollment report, but they also posted a bunch of other interesting stuff from their board meeting as well. In no particular order...

  • I already knew that Massachusetts was among the 30-odd states that UnitedHealthcare was dropping out of. However, it turns out that United is currently covering fewer than 500 of MA's exchange enrollees (considering that MA's entire individual market was only 72,000 people 2 years ago, and exchange enrollment alone is currently 224,000, I'd imagine that there aren't too many off-exchange United enrollees on top of those 500).
  • In addition, Guardian and MetLife are dropping off of MA's dental policy exchange, although according to their monthly report, neither one has any market share via the exchange this year anyway (Altus and Delta seem to make up 100% of the total). (correction: I was looking at the individual dental exchange; Guardian/MetLife are on the small group exchange this year)
  • The MA exchange reports an impressive 94% enrollment retention rate year over year:

The Massachusetts Health Connector has posted their latest monthly enrollment report, and the news is good. As I note every month:

Unlike most states, the Massachusetts Health Connector has not only seen no net attrition since the end of Open Enrollment, but has actually seen a net increase in enrollment...mainly due to their unique "ConnectorCare" policies, which are fully Qualified Health Plans (QHPs) but have additional financial assistance for those who qualify and which are available year-round instead of being limited to the open enrollment period.

As I've noted the past few months, unlike most states, the Massachusetts Health Connector has not only seen no net attrition since the end of Open Enrollment, but has actually seen a net increase in enrollment...mainly due to their unique "ConnectorCare" policies, which are fullly Qualified Health Plans (QHPs) but have additional financial assistance for those who qualify and which are available year-round instead of being limited to the open enrollment period.

The amount of the increase depends on which "official" number you start with; the MA exchange claimed 196,554 people as of 1/31/16...while the ASPE report gives it as 213,883 as of the next day. Presumably they didn't have 17,000 people enroll in a mad rush on February 1st, so there's an odd discrepancy here, but whatever.

A couple of days ago I noted that after two years of nothing but doom & gloom (and coming just a week after UnitedHealthcare pulled the plug on the individual market in over two dozen states) there seems to finally be some positive developments, with companies like Centene and Anthem reporting better-than-expected results. They may not be making a profit yet, but at least they aren't losing money hand over fist the way they did the first couple of years.

I also made a brief mention of the Maryland Co-Op, Evergreen Health, which reported their first quarterly profit since launching 2 1/2 years ago.

Well, according to Adam Cancryn, Evergreen has been joined by at least two other positive Co-Op stories:

Consumer operated and oriented health plans in Maryland, New Mexico and Massachusetts will report profits in the first quarter, in a sign that some of the remaining Affordable Care Act-created nonprofits could be finding their footing on the state exchanges.

In a classic case of missing the forest for the trees, I posted two very wonky, detailed entries over the past couple of days about Minnesota and Connecticut's latest enrollment numbers...but completely missed one crucially important data point.

Investor's Business Daily's Jed Graham picked up on some of my work for his post today, including the enrollment data for both Minnesota and Connecticut...but in addition to that extra data point (which I'll come back to in a moment), he also nabbed the latest number out of a third state, Oklahoma, from one of Adam Cancryn's updates on what I'm calling the UnitedHealthcare Disenrollment Odometer:

I noted last month that the Massachusetts Health Connector had increased their effectuated QHP enrollee total by around 12,000 people in the first month of the off season, which goes against the expected net attition expected once Open Enrollment ends.

However, I also noted that MA is unusual in that most of their exchange QHPs are in the form of "ConnectorCare" plans, which are availble for enrollment year round, just like Medicaid and SHOP enrollment. As a result, this increase, while legitimate, can not be used to extrapolate anything nationally.

The Massachusetts ACA exchange reported exactly 196,554 QHP selections (including the still-qualifying "ConnectorCare" plans) as of January 31st, the final day of the 2016 Open Enrollment Period.

They just held their March board meeting, which always include highly detailed powerpoint charts & graphs running through the end of the prior month...so here's where things stand after the first month of the off season. The main number: The official effectuated enrollment number is up to 208,374 (remember, Massachusetts doesn't even report QHP enrollees until they've actually paid their premium. It'd be awesome if every other exchange was able to do so as well, as that would finally kill off the "But how many have PAID??" talking point once and for all.

Some of the ACA provisions have been a huge success, such as the Medicaid expansion program, which has added over 14 million people to the program over the past 3 years. Others can be viewed as being successful or so-so depending on your POV, like the 12.7 million people who have enrolled in private policies via the ACA exchanges.

And then there are the portions of the law which have gone, well, not so great, to put it mildly...in particular the non-profit, public/private hybrid Co-Ops, which are the only remaining remnant of the originally much-hoped-for "Public Option". For a variety of reasons, not the least of which was an utterly unnecessary and ultimately pointless stunt pulled by Marco Rubio and other Congressional Republicans (aka the Risk Corridor Massacre), over half of the two dozen Co-Ops nationwide melted down in spectacular fashion last fall, leaving only 11 of them surviving into 2016 after the dust settled.

In light of this, I figured it would be worth posting some positive Co-Op news for a change. First up, Ohio.

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